Health Professionals: EEA and Non-EEA Citizens

Baroness Hussein-Ece Excerpts

Thursday 8th September 2011 Lords Chamber

[Baroness Hussein-Ece]

My Lords, I thank the noble Viscount, Lord Bridgeman, for securing this very important debate.

Since the inception of the NHS in 1948, it has relied heavily on overseas-trained nurses and staff to bolster its workforce. The NHS was built with the help of immigrant workers and professionals from across the world when the call went out around the empire that the UK needed their labour. Thousands of doctors and nurses migrated here from the West Indies, as it then was, Pakistan, India, and elsewhere during the 1950s, 1960s and 1970s. They were recruited in response to a health service in desperate need of health professionals in the post-war years. The value of their huge contribution has always been recognised, and it is that diversity on which the NHS was based and is now run. It has been a success story.

We know that more than 30 per cent of NHS professionals were born overseas. Without them, the NHS would come to a standstill. In some cases the NHS is now less reliant on overseas trained professionals to deliver services, but international recruitment has been regularly used as the main option for employers trying to fill vacancies in both health and social care, and in professions and specialisms with recognised shortages. Many Asian and black health professionals have been the backbone of the NHS, often concentrated in the lowest paid roles, the least glamorous specialisms, and in the least popular parts of the country. Some have faced racism and, for many, there has been slow promotion in their working lives.

There are legitimate concerns that the countries from which the nurses and midwives are recruited suffer from a knowledge and skills drain, reducing their capacity to provide healthcare to their own populations. But there have been huge advantages when professional staff have returned to their country of origin, taking with them the skills and development that they have acquired here. No one is advocating uncontrolled immigration but the introduction of a cap on non-EU health workers is insulting to those doctors and nurses who came to work in Britain’s hospitals. Many of them have faced difficult circumstances but have made enormous contributions. In light of the increasing evidence of how reliant we are on migrant workers, the cap could have unintended consequences by blocking much needed specialist workers from settling in Britain when they are vital for our economy and public services.

Social care is another area which is being hit by these procedures. It remains one of the lowest-paid sectors, and it is notoriously difficult to recruit for here in the UK. The National Care Association paints a rather stark picture of the policy's impact on social care. It is already complaining that the care sector cannot get the workforce needed to deliver services in this country. It is estimated that 1 million extra workers will be needed to support the UK's ageing population by 2025. In 2007, one in three care workers was recruited from outside the UK, while an estimated 60 per cent of London care workers were non-EU migrants. Meanwhile, we have the same problem with children's services where there has also been a cap, putting vulnerable children at risk because of the shortage of qualified and experienced social workers in some parts of the country, particularly in London. While measures put in place to train people from the UK and EU for roles now filled by non-EU migrant workers will help, it will take more than three years to have enough suitably qualified candidates to fill these positions.

I believe that successive Governments have failed to put the compelling case to the UK public that communities, from hospitals to schools, right through to local authorities, need to be encouraged to develop a more realistic understanding of immigration matters in this respect, and of how reliant we are on skilled migrant workers for our public services. In addition, we need to shape a practical, common-sense approach to this issue, one that reflects our heritage and our values.